Fungi cause a wide spectrum of diseases. The most common examples are localized infections of the skin and mucous membranes, such as tinea pedis, vaginal yeast infections and infections of keratinized nails. Tinea pedis, also known as athlete's foot, is a form of ringworm associated with highly contagious yeast-fungi colonies. Tinea pedis is estimated to be the second most common skin disease in the United States behind acne, and up to 15% of the population may manifest the disease. Based on a review, tinea pedis may be present in a particular patient as one of the several syndromes. Typically, three variants are seen as shown in the following:    a) Interdigital type of tinea pedis.            This is the most common form usually manifested in the interspace of the fourth and fifth digits, and may spread to the underside of the toes. Patients often complain of itching and burning sensations on the feet accompanied by malodor.            b) Moccasin type tinea pedis            This type is a more severe, prolonged form of tinea pedis that covers the bottom and lateral aspects of the foot. Its appearance is in the form of a slipper or moccasin. The skin of the inflamed area in this type of infection is often scaly and hyperkeratotic with erythema around the soles and sides of the foot.            c) Vesiculobullous type of tinea pedis            This type comprises pustules or vesicles on the instep and adjacent plantar surfaces of the feet, and is less common.        
Both non-pharmacological and pharmacological treatments are applied to treat tinea pedis. Non-pharmacological treatment focuses on educating patients about the predisposing factors, and the chronic nature of the disease. The patients should try to eliminate the moisture that provides the environment for infection.
Keeping the feet clean and dry with the toenails trimmed reduces the incidence of skin disease on the feet. Wearing open-toed shoes and avoiding skin maceration are also recommended. However, some patients may not be able to wear the open-toed shoes due to reasons of etiquette, safety, or work requirements. In the market, there are some hygienic products such as anti-bacteria or anti-odor socks for common use. Silver ions or ceramic magnetic powders are used to eliminate bacteria resulting in controlling the odor-causing bacteria and preventing bad odor. However, for tinea pedis patients, these products are not suitable due to the lack of pharmacological treatment.
Pharmacological treatments involve the use of topical antifungal agents such as ketoconazole, terbinafine, econazole, or cicloprox creams. The treatments are applied onto the normal skin about 2 cm beyond the affected area. For example, 1% terbinafine cream is applied twice a day for one week. However, the data have shown that this kind of treatment fails to cure about one-third of patients with tinea pedis. Most of the relapses are due to poor compliance as the topical treatment should continue a minimum of one more week after the symptoms have cleared up.
In order to increase the successful rate of curing patients with tinea pedis and reduce the chances of relapse, there is a strong need to design and develop a convenient pharmacological treatment and protective measure which will reduce the suffering of disease symptoms.